Public Health Wales Health Protection Team
Exclusion Period for Common Infections (July 2024)
Including A-Z of Common Infections and Next Steps
The table below is a guide on whether an individual with an infection should attend a setting e.g., a school or workplace. This is based on the level/period of infectiousness and not on whether the individual is well enough to attend. If uncertain, individuals should stay at home and seek advice from NHS Direct Wales 0845 46 47 (NHS 111 where available), their Pharmacy or General Practitioner (GP). If a setting requires advice on infections and length of time an individual should be kept away from the setting (exclusion period) then they are asked to:
- Refer to the information table below.
- Seek advice, if required, from relevant health professionals such as GP, Pharmacy, Health Visitor, School Nurse, Midwife, etc.
- In the case of staff illness/exposure contact their own Occupational Health Team.
- Contact the Health Protection All Wales Acute Response (AWARe) Team on 0300 003 0032 or via e-mail aware@wales.nhs.uk if directed to do so below.
- Closing a setting due to infection control is very rare, you do not need to close your setting unless advised to after speaking to the Health Protection Team.
When there are local/national outbreaks of illness, settings will usually be informed and advised of any actions they are required to take by the Health Protection/All Wales Acute Response Team. Settings are asked to keep a register of unwell individuals and also have a register of individuals who may be considered vulnerable to infection. If there are two or more cases of an infection; or more than the usual number of a common infection, then the setting should seek advice from the Health Protection (AWARe) Team.
| Illness and Infections | Length of time an Individual is to be kept away from setting (Exclusion Period) | Do Childhood Settings Including Nurseries/
Schools Need to Notify Public Health Wales? (AWARe) |
Advice and Next Actions | Comments | ||||
| SKIN AND RASHES
|
||||||||
| Unexplained rashes should be considered infectious until health advice is obtained from a clinician.
NHS 111 Wales – Health A-Z : Skin rashes in babies and children
|
||||||||
| Athlete’s Foot | None | No | · Do not allow people who have the infection to share socks, shoes, towels, or bathmats with others.
· Ensure the individual wears a rubber sock whilst swimming. · Parents/guardians should seek advice from their local pharmacists. |
Athletes’ Foot is not a serious condition, but treatment is recommended. | ||||
| Chickenpox | YES, 5 days from onset of rash AND until all vesicles (blisters) have crusted over, (dried up). | Yes, BUT ONLY if Chickenpox and/or influenza are circulating at same time and same setting, (e.g., Classroom, Nursery) as Scarlet Fever. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. · Send any individual with chickenpox home. Keep the individual away from the setting until all blisters have crusted over. |
Infectious for 24 hours before onset of rash. SEE: Vulnerable Individuals and Pregnancy (below).
PHW will initially advise on management of the incident ONLY IF Chickenpox and/or Influenza are circulating at same time and same setting, (e.g., within the same classroom, and withing the same Nursery) as scarlet Fever. |
||||
| Cold Sores
(Caused by Herpes Simplex) |
None | No | · Spread by direct contact, especially contact with the fluid of a cold sore or the saliva of someone with the virus
· Contact local pharmacist if not improving. · Avoid kissing and contact with the sores. · Avoid the use of cups/utensils which may be shared in setting. · Avoid sharing towels, flannels, toothbrushes, and razors |
Cold Sores are generally mild and self-limiting. | ||||
| German Measles
(Rubella)* |
YES, exclusion for five days from onset of rash. (1st day of rash is classed as day 0) | Yes, if child attended the setting 7 days before and within the 7 days after the rash appeared. Notification normally received from GP or Clinician to AWARe, (Public Health Team). | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys must be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. |
Preventable by vaccination and covered by the routine immunisation schedule (MMR x 2 doses). SEE: Vulnerable individuals and Pregnancy (below) Pregnant staff should seek prompt advice from their GP or Midwife.
Encourage all staff to find out their MMR status- if unsure, advise them to contact their GP to discuss. |
||||
| Hand, Foot and Mouth (Coxsackie Viral Infection) | None | No | · Spread is caused by direct contact with the secretions of the infected person (including faeces) or by aerosol spread such as coughing and sneezing.
· The virus can remain in the faeces for a few weeks after the initial infection. · Encourage individuals to implement good hand hygiene practices, particularly in those staff who carry out nappy changing or assist with toileting in individuals with symptoms. |
Not to be confused with Foot and Mouth disease in animals.
Not a known risk in pregnancy but any pregnant staff should discuss with their Midwife or GP. SEE: Vulnerable Individuals and Pregnancy (below). |
||||
| Impetigo
(Milder infections caused by group A streptococcus include scarlet fever, impetigo and ‘strep throat’. These can be easily treated with antibiotics) |
YES, exclusion until affected areas are crusted and healed, or 48 hours after commencing antibiotic treatment. | No | · Encourage individuals to maintain good hand hygiene.
· Discourage children, young people and staff touching or scratching the sores, or letting others touch them. · Do not allow towels, flannels, toothbrushes and eating and drinking utensils to be shared by others. · Ensure that equipment, including toys and play equipment are thoroughly cleaned daily. · Non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. |
Antibiotic treatment speeds up healing and reduces the infectious period. | ||||
| Measles* | YES, four days from onset of rash. (1st day of rash is classed as day 0). | YES, if child attended the setting 4 days before and the 4 days after the rash appeared. Notification normally received from GP or Clinician to AWARe, (Public Health Wales). | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. · If able discuss with parents’/guardians’ vaccination if individual is unvaccinated. |
Preventable by vaccination and covered by the routine immunisation schedule (MMR x 2 doses is the recommended. Schedule in the UK). SEE: Vulnerable Individuals and Pregnancy (below). Pregnant individuals should contact their Midwife or GP as soon as possible to assess their immunity.
Encourage all staff to find out their MMR status if unsure, advise them to contact their GP to discuss. |
||||
| Molluscum Contagiosum | None | No | · Should seek advice of Pharmacist or GP.
· Normal hand hygiene and personal hygiene should be maintained. |
A self-limiting condition that may continue for up to 18 months. | ||||
| Ringworm | YES, until treatment has been commenced. | No | · Good hand hygiene.
· Continue with high level of individual hygiene. · If on individuals’ feet, ensure feet are covered. · Ensure environmental cleaning is carried out daily. · Refer to GP |
Keep area affected covered. Treatment is recommended | ||||
| Scabies | YES, affected individual can return 24 after first treatment. | Only notify HPT if more than two cases in the setting, (same classroom and similar time frame). | · Affected cases should seek advice and treatment from either GP or local pharmacist.
· Household contacts of the case do not need to be excluded but will need to be treated at the same time as the affected individual. · Do not share towels or flannels during the treatment phase. · Ensure good hand hygiene maintained. |
Household and close contacts require concurrent treatment | ||||
| Scarlet Fever*
(Milder infections caused by group A streptococcus include scarlet fever, impetigo and ‘strep throat’. These can be easily treated with antibiotics) |
YES, individuals can return after full 24 hours of appropriate antibiotics, if not treated with antibiotics the individual should not return until symptoms have resolved. | YES, only if there are 2 or more confirmed cases in a classroom setting, within 10 days of each other. Please consult with the Health Protection Team if Flu and/or Chickenpox is circulating at same time as Scarlet Fever in the setting, or if an individual has attended or been hospitalised. | · Each single case of Scarlet Fever should be notified to PHW via the GP or Clinician assessing the individual.
· Encourage good hand hygiene. · Increased touch point cleaning. · Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water maybe temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. · Discourage play with items/toys that are unable to be cleaned effectively. |
Antibiotic treatment recommended for the affected individual. Please consult with Health Protection Team if Flu and/or Chickenpox circulating at same time and the same setting as Scarlet Fever or if you are aware a child has attended or been hospitalised due to Scarlet Fever. | ||||
| Streptococcal A (also known as Strep Throat) See also Tonsillitis.
(Milder infections caused by group A streptococcus include scarlet fever, impetigo and ‘strep throat’. These can be easily treated with antibiotics) |
YES, individual can return after full 24 hours of appropriate antibiotics. | No, not unless there are several cases, any hospitalised individuals or cocirculating Chickenpox and or Influenza, (Flu) | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water Should be temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. |
Some Pharmacists will offer point of care throat swabbing to test for Streptococcus Group A. | ||||
| Slapped Cheek/Fifth Disease/Parvovirus B19 | None | No | · Any pregnant, (especially under 20 weeks gestation), or any immunocompromised individuals need to seek clinical advice either from their GP, Midwife, or their Consultant Specialist. | SEE: Vulnerable Individuals and Pregnancy (below)
Once rash has appeared the individual is no longer infectious, (cannot pass the virus on to other). Pregnant individuals should contact their Midwife or GP as soon as possible. |
||||
| Shingles, (this infection is caused by the same virus as Chickenpox, this virus can remain in the body and sometimes is reactivated, and this is known as Shingles). | Individual only to be kept away from setting if rash is weeping and cannot be covered. | No but need to notify PHW if cocirculating Scarlet Fever, Flu or Chickenpox. | · If the child is attending School/Nurseries ensure all dressings are clean, dry and intact.
· If not contact parents/guardians to discuss collecting the child. · In cases of shingles, the decision to exclude an individual will depend on whether the rash or blisters can be covered. Keep the individual away from the setting if they have a weeping shingles rash that cannot be covered. |
Can cause chickenpox in those who are not immune i.e., have not had chickenpox. It is spread by contact with the vascular fluid from blisters).
Pregnant individuals should contact their Midwife or GP as soon as possible. SEE: Vulnerable Individuals and Pregnancy (below) |
||||
| Warts and Verrucae | None | No | · Verrucae should be covered in swimming pools, gymnasiums and changing rooms.
· |
Treatment can be sourced at the local Pharmacist or GP Practice. | ||||
| Gastroenteritis illness | ||||||||
| Clostridioides Difficile (formerly known as Clostridium Difficile/C.diff) | YES, to stay away from setting 48 hours from last episode of diarrhoea. | Any concerns contact Health Protection Team who will assess the incident. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning especially toilets and nappy changing areas. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · It is recommended that a bleach-based product is used in accordance with manufacturers guidelines. |
If there are two or more cases in a setting, please seek advice from the Health Protection Team. | ||||
| Cryptosporidiosis
|
YES, to stay away from setting 48 hours from last episode of diarrhoea. | Notification normally received from GP or Clinician to PHW but will be followed up by the Local Environmental Team. | · Good hand hygiene.
· Increased touch point cleaning · Affected individuals should not swim for two weeks after the last episode of diarrhoea. · If attending petting farms and or feeding animals, ensure individuals perform appropriate hand hygiene immediately after contact with animals or surfaces. · Enhanced environmental cleaning especially toilets and nappy changing areas and high touch contact areas. This includes toys, non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. |
Use gloves and apron when handling blood or bodily fluids such as vomit or diarrhoea.
Ensure correct storage of soiled clothing (separate from clean coats clothing etc) Ensure correct disposal of soiled nappies. |
||||
| Diarrhoea and/or vomiting
(inc Norovirus- also known as “Winter vomiting bug”)
|
YES, 48 hours from last episode of diarrhoea or vomiting. | Yes, only If there are two or more cases in a similar setting, please inform the Health Protection Team/ local Environmental Health Officer | · Good hand hygiene using soap and water.
· Increased touch point cleaning. · Enhanced environmental cleaning, paying particular attention to toilet and kitchen areas. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. NHS 111 Wales – Health A-Z : Diarrhoea and vomiting NHS 111 Wales – Health A-Z : Norovirus
|
Use gloves and apron when handling blood or bodily fluids such as vomit or diarrhoea.
Ensure correct disposal of soiled nappies. If a particular cause of the diarrhoea and vomiting is identified, there may be additional exclusion advice, for example E coli STEC and Hep A which will be followed up by the Local Health Environment Department |
||||
| E. coli O157 STEC*
Typhoid [and Paratyphoid] (Enteric Fever) * Shigella* (Dysentery)
|
YES, keep away from the setting for 48 hours from the last episode of diarrhoea as a minimum.
Some individuals may need to be kept away from the setting until they are no longer excreting the bacteria in their faeces. Microbiological clearance may be required. Always consult with your local Environmental Health Officer/Health Protection Team. |
YES, but Notification normally received from GP or Clinician. Will be followed up by the Local Environmental Health Team. | · Good hand hygiene using soap and water.
· Increased touch point cleaning. · Enhanced environmental cleaning, paying particular attention to toilet and kitchen areas. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · Use gloves and apron when handling blood or bodily fluids such as vomit or diarrhoea. · Ensure correct disposable of soiled nappies. · Person-to-person spread is by direct contact with someone who has the infection particularly within families and childcare settings. Outbreaks and sporadic cases have also been linked with handling animals. Therefore, adults should supervise children and young people while washing their hands during visits to petting zoos and farm centres. NHS 111 Wales – Health A-Z : Dysentery |
Individuals aged 5 years or younger, those who have difficulty in maintaining good personal hygiene, food handlers and care staff need to be kept away from the setting until there is proof that they are not carrying the bacteria (microbiological clearance). Your local Environmental Health Officer and Health Protection Team will give advice in all cases.
Microbiological clearance may also be required for those in close contact with a case of disease. The Environmental Health Officer/Health Protection Team can provide advice if required. |
||||
| Respiratory and others | ||||||||
| Acute Respiratory Illness e.g., COVID-19 (Coronavirus-19) *
(Please also see influenza) |
Children and young people who are unwell and have a high temperature should stay at home and avoid contact with other people, where they can. They can go back to school, college or childcare, and resume normal activities when they no longer have a high temperature, and they are well enough to attend. | No, but see comments. | · Individuals should not attend if they have a high temperature and are unwell.
· Individuals who have respiratory symptoms should not attend the setting until well or at least 48 hours fever clear. (However, if Individuals have tested positive for COVID should follow the local guidance.) · Good hand hygiene. · Increased touch point cleaning. · Enhanced environmental cleaning. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. 111.wales.nhs.uk/selfassessments/symptomcheckers/covid19.aspx NHS 111 Wales – Health A-Z : Cold, common NHS 111 Wales – Health A-Z : Chest infection, Adult Managing acute respiratory infections in special educational schools | GOV.WALES
Guidance for people with symptoms of a respiratory infection, including COVID-19 | GOV.WALES |
Individuals with mild symptoms such as runny nose, and headache who are otherwise well can continue to attend their setting.
Contact PHW if there are higher than previously experienced and/or rapidly increasing number of staff or student absences due to acute respiratory. Evidence of severe disease due to respiratory infection, for example if a child, young person or staff member is admitted to hospital. SEE: Vulnerable Individuals and Pregnancy (below) and Welsh Government advice on People at Increased Risk of Coronavirus |
||||
| Flu (Influenza) | YES, 5 days after onset of symptoms. Can return when no longer symptomatic. Cases who are unwell and have a high temperature should stay at home and avoid contact with others, where they can. They can return to childcare, education environments when they no longer have a high temperature for 48 hours, and they are well enough to attend. | YES, only if Flu and/or Chickenpox circulating at same time as Scarlet Fever in setting. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water maybe temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. |
SEE: Vulnerable Individuals and Pregnancy (below).
Encourage those who are eligible for the Flu vaccine to have. |
||||
| Tuberculosis* | Always consult the Health Protection
Team. Exclusion is only recommended for infective, (active), Tuberculosis. |
YES, but notification normally received from GP or Clinician. | · https://www.nhs.uk/conditions/tuberculosis-tb/
· https://www.gov.uk/government/publications/tuberculosis-tb-and-children |
Requires prolonged close contact for spread Only pulmonary (lung) TB is infectious to others, needs close, prolonged contact to spread.
Siblings of confirmed infectious TB do not need to be excluded from settings, unless advised by TB specialist. |
||||
| Whooping Cough
(pertussis)* (can be referred to as “100 day cough” ) |
YES, see criteria:
Children should be excluded from schools or nurseries for 48 hours following commencement of antibiotics, or for 14 days following the onset of coughing if they are not being treated. Staff working in nurseries and other childcare settings providing care to infants in a priority group (for example, in nursery baby rooms) should be excluded for 48 hours following commencement of recommended antibiotics , or for 21 days following the onset of cough if untreated. Staff in other nursery and childcare settings, schools and other educational settings should be excluded for 48 hours following commencement of antibiotics, or for 14 days following the onset of cough if untreated. Healthcare workers providing close personal care to infants in priority Group 1, or to pregnant women, should be excluded from work as soon as a diagnosis of pertussis is suspected, until 48 hours following commencement of antibiotics, or for 21 days following the onset of cough if untreated. The HCW should in addition inform their occupational health department and infection prevention control team as soon as possible – and should do so even if beyond 21 days from the onset of coughing as vulnerable contacts may still be within their incubation period. |
YES, but notification is normally received from GP or Clinician. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Discourage play with items/toys that are unable to be cleaned effectively. · Play with sand or water should be temporary stopped. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. · If able, discuss with parents’/guardians’ vaccination if individual is unvaccinated. |
Preventable by vaccination and covered by the UK routine immunisation schedule. After treatment, non-infectious coughing may continue for many weeks.
Advise individuals, parents or carer to seek advice from their General Practitioner if they fall into high-risk categories, such as immunosuppressed, pregnant individuals, or unvaccinated persons. |
||||
| Other illness | ||||||||
| Conjunctivitis | No | No | · Advise individuals, parents, or carers to seek advice from their local Pharmacist.
· Encourage the individual not to rub their eyes and to wash their hands frequently. · Advise the affected individual to avoid sharing towels, flannels and pillows. |
Advise individuals, parents, or carers to seek advice from their local Pharmacist or GP. | ||||
| Diphtheria* | YES, must not attend setting. Always consult the Health Protection Team. | YES, but notification normally received from GP or Clinician. | The Health Protection Team will consider the risk of any contact the individual has had with others if necessary. | Preventable by vaccination and covered by the UK Routine Immunisation Schedule. Family contacts must be kept away from setting until cleared to return by the Health Protection Team. | ||||
| Eye and Ear Infections | None | No | · Advise individuals, parents, or carers to seek advice from their local Pharmacist.
· Encourage the individual not to rub their eyes or ears and to wash their hands frequently. · Advise the affected individual to avoid sharing towels, flannels, and pillows. |
As both viruses and bacteria can cause eye and ear infections, not all will require antibiotic treatment. | ||||
| Glandular Fever | None | No | · Encourage individuals to implement good hand hygiene and respiratory hygiene practices.
· The virus is found in the saliva of infected people and can be spread by direct contact with saliva such as kissing, being exposed to coughs and sneezes, and sharing of eating and drinking utensils. · It can also be spread by indirect contact via contaminated objects if hands are not washed adequately. |
Infectious for up to 7 weeks before symptoms start. Glandular fever can cause spleen swelling so avoid sports or activities that might increase risk of falling and damaging spleen. | ||||
| Head Lice | None | No | · Encourage parents or carers to give regular head checks and provide good hair care to help identify and treat head lice early. | Treatment is recommended only in cases where live lice have been seen.
Please visit your local Pharmacist for advice and treatment. |
||||
| Hepatitis A* | YES, but notification normally received from GP or Clinician. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning particularly toilet areas. · Gloves and apron should be worn when changing soiled nappies. · Soiled nappies should be stored away from clean cloths and areas until disposed of correctly. · Toys should be wiped down and non-washable items, for example soft toys should be wiped or washed with a detergent using warm water and dried thoroughly. · Play with sand or water should be temporary stopped. |
If there are two or more cases in a setting the Health Protection Team will advise on the control measure which maybe could include vaccinations.
Educate young people on safe sex to protect them from hepatitis infection (and other sexually transmitted infections) through sexual contact. A lesson plan is available to support. |
|||||
| Hepatitis B*, C*,
HIV |
None | Notification normally received from GP or Clinician. | Where there has been blood spillage, nosebleed, bleeding cut or any blood contamination, please follow the below guidelines
· Ensure correct personal protective equipment is worn. · Good hand hygiene. · Correct disposal of blood-stained items used. · Ensure blood-stained clothing is stored separately and parents’ guardians are advised to wash separately at high temperature as soon as possible. · There should be no sharing of toothbrushes or shavers/razors. · Clean the area with the appropriate cleaner/disinfectant NHS 111 Wales – Health A-Z : Hepatitis B |
Hepatitis B and C and HIV are blood borne viruses that are not infectious through normal social contact. | ||||
| Meningococcal
Meningitis/Septicaemia* |
YES, until they have received the appropriate antibiotic treatment. Always consult the Health Protection Team. | YES, but notification normally received from GP or Clinician. | · Exclude the infected individual until they have been treated with antibiotics and are well enough to resume normal activities.
· Do not exclude household and close contacts unless they have symptoms suggestive of meningococcal infection. · Discuss vaccination with parents’/guardians if individual is unvaccinated. |
Several types of meningococcal disease are preventable by vaccination. PHW will contact individual settings if further actions are required. | ||||
| Haemophilus Influenzae Type B (Hib) Meningitis/Septicaemia* | YES, until they have received the appropriate antibiotic treatment. Always consult the Health Protection Team. | YES, but notification normally received from GP or Clinician. | · There is no effective medication for the treatment of viral meningitis, but symptoms are usually much milder.
NHS 111 Wales – Health A-Z : Hib (Haemophilus influenzae type b) |
Haemophilus Influenzae Type B (Hib) is preventable by vaccination and is part of the UK Routine Childhood Immunization Schedule. There is no reason to keep siblings or other close contacts of the affected individual from attending settings. If two or more cases within 4 weeks, contact the Health Protection Team. | ||||
| Meningitis viral* | No | YES, but notification normally received from GP or Clinician. | · No enhanced cleaning required only continue with routine clean schedules.
· Good hand hygiene |
Milder illness. There is no need for the Health Protection Team to identify people the individual has been in contact with. There is no reason to exclude siblings and other close contacts of the affected individual from settings. | ||||
| Methicillin Resistant Staphylococcus Aureus (MRSA) | None | Notification normally received from GP or Clinician. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. · Wounds should be covered. |
Good hygiene, in particular hand washing and environmental cleaning, are important to minimise spread. | ||||
| Mumps* | YES, five days after onset of jaw/neck swelling. | YES, but notification normally received from GP or Clinician. | · Good hand hygiene.
· Increased touch point cleaning. · Enhanced environmental cleaning. · Encourage good “Cough etiquette” – Catch it, Bin it Kill it message. · Discuss vaccination with parents’/guardians if individual is unvaccinated. |
Preventable by vaccination and covered by the Routine Immunisation Schedule (MMR x 2 doses). All children and staff should be encouraged to be vaccinated
See Vulnerable Staff. |
||||
| Threadworms | None | No | · Pharmacies can advise on treatment.
· Re-infection is common and infectious eggs are also spread to others directly on fingers or indirectly on bedding, clothing and environmental dust. · Regular hand washing, laundry and regular cleaning can help reduce the risk of infection and re-infection. · Transmission is uncommon in education or childcare settings. · Fingernails should be kept short. |
Treatment is recommended for the child and household contacts – should contact their pharmacist or GP | ||||
| Tonsillitis | None usually. If tonsillitis caused by Group A Streptococcus (sometimes referred to as ‘Strep throat’), individual can return 24 hours after commencing appropriate antibiotic treatment. | No | · For prolonged sore throats please contact your local Pharmacy who may have a point of care test to identify Group A strep infection, which then can be treated. | There are many causes for Tonsillitis, but most are due to viruses and therefore do not require antibiotics. Antibiotic treatment recommended for the affected individual if Tonsillitis caused by Group A Streptococcus (‘Strep A’). | ||||
*Denotes a notifiable disease/organism. It is a statutory requirement that doctors report a notifiable disease to the Proper Officer of the Local Authority (usually a Consultant in Communicable Disease Control/Health Protection).
Vulnerable Individuals
Some medical conditions make people vulnerable to infections that would rarely be serious in most people. These include those being treated for leukaemia or other cancers, on high doses of steroids and with other conditions that seriously reduce immunity.
Pregnancy
If a woman develops a rash during pregnancy or is in direct contact with someone with a rash or an infection, they should ask their GP/Midwife if they need any relevant investigations e.g., blood test. The greatest risk during pregnancy from infections comes from their own child/children, rather than the workplace.
NHS 111 Wales – Pregnancy Guide
Immunisation
All individuals are encouraged to ensure they have received all the vaccines that are offered in the UK schedule. If anyone is uncertain which vaccines, they have received they should contact their GP surgery. For further information about the immunisation schedule please visit the vaccination section in NHS 111 Wales – Vaccinations
Other information can be found on https://111.wales.nhs.uk
Further IPC guidance can be found on Guidance – Public Health Wales (nhs.wales)
Infection Prevention & Control – Public Health Wales (nhs.wales)
Guidance for childcare, preschool and educational settings – Public Health Wales (nhs.wales)
Catch it Bin it Kill it campaign catch it bin it poster – Bing images Catch it, Bin it, Kill it Poster – Infection Prevention Control Catch it, Bin it, Kill it – Respiratory and hand hygiene campaign (2011) – GOV.UK (www.gov.uk)
Rydym yn croesawu galwadau ffôn yn Gymraeg / We welcome phone calls in Welsh
© 2024 Public Health Wales NHS Trust
Material contained in this document may be reproduced under the terms of the Open Government Licence (OGL) www.nationalarchives.gov.uk/doc/open-government-licence/version/3/ provided it is done so accurately and is not used in a misleading context. Acknowledgement to Public Health Wales NHS Trust to be stated.
Copyright in the typographical arrangement, design and layout belongs to Public Health Wales NHS Trust
Produced by Health Protection Team, Public Health Wales
Produced: 22nd August 2018 (v1); Revised July 2024 (v.7) Date of Next Review: July 2025